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Literature Research

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Submitted By student1314
Words 1143
Pages 5
BEATRISA SHEKHTER
NRS 433-V
Literature Search

Wound Care is very important topic in modern medical field. Pressure ulcers are the major problem in the long term facilities. Having an understanding of the exact cause of pressure ulcers helps place the role of repositioning into context. Demographic and epidemiological data suggest that health-care demand will increase considerably in the future as a result of an ageing population and a rise in the prevalence of chronic diseases such as diabetes. This phenomenon has come to be referred to as the ‘health care time bomb’ in the popular press and political discourse. The authors seek to look beyond the headlines and political rhetoric to clarify the extent to which they reflect the likely future reality with a specific focus on wound management. The present-day burden that wounds and current wound management practices place upon the health-care system are detailed and clarified, and the potential future implications of increasing wound prevalence on the current picture are explored. Possible opportunities to enhance current wound management practice as identified in the analysis are discussed. Declaration of interest: Alistair Biel by is a contractor for Smith & Nephew. Richard Searle is and employee of Smith & Nephew. This project was supported by an unrestricted grant from Smith & Nephew. As such, a pressure ulcer is defined as localized injury to the skin and/or underlying tissue, usually over a bony prominence, as a result of pressure or pressure in combination with shear. A number of contributing or confounding factors are also associated with pressure ulcers; the significance of these factors is yet to be elucidated. It can thus be seen that the causative factors related to pressure ulcer development are pressure and shear, with the intensity and duration of pressure/shear being of significant importance. Healthcare professionals can help to control the intensity of pressure/shear by changing the support surface and reducing the duration of pressure through the use of repositioning. The top tips presented here address the key considerations when using repositioning as a component of pressure ulcer prevention strategies. Traditionally, it was felt the main impact of externally-applied mechanical forces on tissues was that they caused localized ischemia there by altering the perfusion of the affected area. However, it is now thought that ischemia alone is insufficient to explain how pressure ulcers develop [2]. Understand what you can do about pressure ulcer risk: The prevention of pressure ulcers involves a myriad of different interventions, including nutritional care pressure-reducing/-relieving surfaces and skin and wound care. Repositioning patients is also an important component in the prevention of pressure ulcers.(1)
A combination of supplements and vitamins has been reported to accelerate wound healing. Healthy subjects who were supplemented orally had a significant increase in plasma ARG and ornithine levels which resulted in enhanced rate of collagen synthesis.(4) Combination of supplements, vitamins and other preventative measure are very helpful in promotion of wound healing. People who has poor nutrition intake must have all supplements and vitamins to prevent bed sores. (3)
A pressure ulcer is a localized injury to the skin or underlying tissue, usually over a bony prominence, as a result of unrelieved pressure. Predisposing factors are classified as intrinsic (e.g., limited mobility, poor nutrition, comorbidities, aging skin) or extrinsic (e.g., pressure, friction, shear, moisture). Prevention includes identifying at-risk persons and implementing specific prevention measures, such as following a patient repositioning schedule; keeping the head of the bed at the lowest safe elevation to prevent shear; using pressure-reducing surfaces; and assessing nutrition and providing supplementation, if needed. When an ulcer occurs, documentation of each ulcer (i.e., size, location, eschar and granulation tissue, exudate, odor, sinus tracts, undermining, and infection) and appropriate staging (I through IV) are essential to the wound assessment. Treatment involves management of local and distant infections, removal of necrotic tissue, maintenance of a moist environment for wound healing, and possibly surgery. Debridement is indicated when necrotic tissue is present. Urgent sharp debridement should be performed if advancing cellulitis or sepsis occurs. Mechanical, enzymatic, and autolytic debridement methods are non urgent treatments. Wound cleansing, preferably with normal saline and appropriate dressings, is a mainstay of treatment for clean ulcers and after debridement. Bacterial load can be managed with cleansing. Topical antibiotics should be considered if there is no improvement in healing after 14 days. Systemic antibiotics are used in patients with advancing cellulitis, osteomyelitis, or systemic infection. Pressure ulcers, also called decubitus ulcers, bedsores, or pressure sores, range in severity from reddening of the skin to severe, deep craters with exposed muscle or bone. Pressure ulcers significantly threaten the well-being of patients with limited mobility. Although 70 percent of ulcers occur in persons older than 65 years,1 younger patients with neurologic impairment or severe illness are also susceptible. Pressure ulcers are caused by unrelieved pressure, applied with great force over a short period (or with less force over a longer period), that disrupts blood supply to the capillary network, impeding blood flow and depriving tissues of oxygen and nutrients.(5) All of that preventable but even in 2014 Wound Care is suffer from not enough study and researches.

1. Journal of Wound Care (J WOUND CARE), 2014 Nov; 23 (11): 552-62. 2. Wounds International (WOUNDS INT), 2014 Sep; 5 (3): 6-9. (34 ref)
Abstract: Research in wound care explained that prevention method is the best for bed sores. Prevention methods can keep resident from pressure ulcers which can lead to sepsis and osteomyelitis which can lead to the death of the resident. Prevention measure such as skin barrier, pressure relief mattress, turning and reposition patient every 2hrs/prn can prevent people from bed sores and do not make them suffers from pain and possible systemic sepsis. 3. Nutrition & Dietetics (NUTR DIET), 2011 Sep; 68 (3): 208-13. (21 ref)
Abstract: Pressure ulcers are a serious issue in the long term facilities. The objective of the present study was to determine whether an arginine-containing nutritional supplement can reduce the healing time of pressure ulcers in people with spinal cord injuries compared with those not consuming the supplement until full wound healing. Nutrition and supplements all together working really good to promote wound healing in geriatric patients. 4. Journal of Wound Care (J WOUND CARE), 2014 May; 23 (5): 259-69. (30 ref)
Abstract: Pressure ulcers were measure every week for length, width and depth. To use supplements make pressure ulcer to be healing. Supplements such as: Zinc sulfate, Multivitamins, Vitamin C, LPS protein (regular), LPS protein (sugar free) which is very helpful to promote wound healing. 5. Evidence Based Nursing (EVID BASED NURS), 2007 Apr; 10 (2): 54. (2 ref)
Abstract: Pressure ulcers are common in a variety of patient settings and are associated with adverse health outcomes and high treatment costs.

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